Wright M E, McCrea H, Stringer M, Murphy-Black T
School of Health Sciences - Nursing, University of Ulster, Coleraine, Co. Londonderry, Northern Ireland.
J Adv Nurs. 2000 Nov;32(5):1168-77. doi: 10.1046/j.1365-2648.2000.01587.x.
Personal control is a central feature of women's involvement in their childbirth experiences. To achieve this control tacit rules and guidelines are applied to define how women and the professionals who care for them should behave. This study investigated the extent to which women exercised control in pain relief during the first stage of labour by comparing (a) the rules which they held prior to childbirth (2-3 cm cervical dilatation) with those which they afterwards felt applied to their labour and (b) the rules held by the women before and after childbirth with those held by the midwives. In a quantitative study using a repeated measures design, a questionnaire was administered to 35 midwives and to 100 women prior to and within 24 hours following their delivery. Consistency of the women's scores before and after childbirth, indicated by few statistically significant differences, tended to confirm their rules on control of pain relief. Some of the rules were held even more strongly following childbirth. A surprising finding was the even stronger agreement by midwives with some of the rules. There was a definite trend for many of the rules held by the women prior to childbirth to increase following birth towards those of the midwives. This could be the result of the experience of childbirth per se but the possibility that it was contributed to by the influence of the midwives cannot be ruled out and warrants further research. An interesting hierarchy in the rules for compliance with professional care has been highlighted.
个人掌控是女性参与分娩经历的一个核心特征。为实现这种掌控，人们运用默认的规则和指导方针来界定女性及其护理专业人员应有的行为方式。本研究通过比较：(a) 女性分娩前（宫颈扩张2 - 3厘米）持有的规则与她们之后认为适用于自己分娩的规则；以及(b) 女性分娩前后持有的规则与助产士持有的规则，调查了女性在第一产程疼痛缓解过程中行使掌控的程度。在一项采用重复测量设计的定量研究中，在35名助产士和100名女性分娩前及分娩后24小时内对她们进行了问卷调查。分娩前后女性得分的一致性（统计上几乎没有显著差异）倾向于证实她们关于疼痛缓解控制的规则。有些规则在分娩后持有得更加坚定。一个惊人的发现是助产士对其中一些规则的认同甚至更强。女性分娩前持有的许多规则在产后朝着助产士的规则方向有明显的增加趋势。这可能是分娩本身经历的结果，但助产士的影响导致这种情况的可能性也不能排除，值得进一步研究。研究突出了遵守专业护理规则方面一个有趣的层级关系。
